Trends in the Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors across Educational Level in the 1995-2005 Period

PURPOSE: To determine the differences and trends in the prevalence, awareness, treatment and control of cardiovascular risk factors and lifestyle variables across educational level in the 1995-2005 period in a country with a universal free health care system. METHODS: Data from three consecutive independent population-based surveys were used. Cardiovascular risk factors, lifestyle variables, and self-reported educational level were collected in 9646 individuals ages 35-74 years throughout the decade. RESULTS: The prevalence of hypertension and diabetes was inversely associated with education. An increase in the proportion of hypertension and dyslipidemia awareness, treatment, and control in all educational level groups was observed. This increase was greater among the lowest education group, reducing the disparities between groups. The prevalence of lifestyle-related risk factors decreased in the greatest but increased in the lowest education group, widening the disparities between groups. CONCLUSIONS: A universal free health care system is effective in avoiding inequalities in the diagnosis, treatment, and control of cardiovascular risk factors. However, other social determinants seem to explain the social inequalities in the prevalence of these risk factors and in the adoption of healthy lifestyles. Ann Epidemiol 2011;21:555-563. (C) 2011 Elsevier Inc. All rights reserved.